Fine tuning for quality of life: 21st century approach to treatment of Addison’s disease
Abstract
Despite treatment with glucocorticoids and mineralocorticoids, the ability to work and quality of life of patients who have adrenal insufficiency remains low. There are no helpful objective measures of optimal glucocorticoid replacement, so this is best achieved by careful clinical assessment. Adequacy of mineralocorticoid replacement may be judged by assessing postural change in blood pressure, serum electrolytes, and plasma renin activity. Novel delayed-release and sustained-release formulations of hydrocortisone seem to more closely mimic diurnal serum cortisol rhythms than conventional hydrocortisone tablets. Such preparations are currently being evaluated and may play a role in management of patients who have adrenal insufficiency.
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Long-term HRQoL in patients with Addison's disease appears to be inversely related to the delay in establishing the diagnosis after disease onset.
“Moreover, longterm HRQoL in these patients appears to be inversely related to the delay in establishing the diagnosis after disease onset, emphasizing the importance of recognizing the disease early (5,6).”
From Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [5]
In general, there is an association between the severity of the CAH phenotype and the level of gonadal dysfunction and fertility in women.
“In general, there is an association between the severity of the CAH phenotype and the level of gonadal dysfunction and fertility(625).”
From Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management (2022) · cites this paper as [625]
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- Authors
- Reisch, N., & Arlt, W.
- Affiliations
- University of Birmingham (GB)
- Venue
- Endocrinology and Metabolism Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2009-06
- Volume
- 38
- Issue
- 2
- Pages
- 407-418
- ISSN
- 0889-8529 (ISSN-L)
- OpenAlex
- W2074926108
- Cited by
- 36
- References
- 10
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 2 · 2021: 4 · 2019: 3 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 6 · 2013: 3 · 2012: 4
- FWCI
- 0.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrinology and Metabolism Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- Addison's disease, adrenal insufficiency, glucocorticoid replacement therapy, cortisol, mineralocorticoid replacement, quality of life, sustained-release formulation, diurnal cortisol rhythm, plasma renin activity, serum electrolytes, postural blood pressure
- MeSH terms
- Addison Disease, Humans, Quality of Life
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